Basic Information
| Provider Information | |||||||||
| NPI: | 1013407535 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GONZALES | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | SINAY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1203 TWINING OAKS LN | ||||||||
| Address2: | |||||||||
| City: | MISSOURI CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774892113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108873295 | ||||||||
| FaxNumber: | 2108873295 | ||||||||
| Practice Location | |||||||||
| Address1: | 8610 MARTIN LUTHER KING BLVD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770332308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137340199 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2018 | ||||||||
| LastUpdateDate: | 05/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP136132 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.